In March of 2013, Gordon Freedman, a doctor on Manhattan’s Upper East Side, fielded a request from a regional sales manager for the manufacturer of Subsys, a spray form of the highly addictive painkiller fentanyl.
Dr. Freedman was already a top prescriber of Subsys and also one of the company’s paid promotional speakers. Now the sales manager was telling him the company, Insys Therapeutics, would increase the amount of money it was paying him and asked that he increase the number of new patients he was prescribing Subsys.
“Got it,” Dr. Freedman replied, according to authorities. By 2014, Dr. Freedman had become one of the country’s top prescribers of the painkiller drug — and also one of the company’s highest-paid speakers.
The exchange between the doctor and Insys was detailed in a federal indictment unsealed on Friday in Manhattan, charging Dr. Freedman, of Mount Kisco, N.Y., and four other New York doctors with participating in a bribery and kickback scheme that prosecutors said sought to increase the drug company’s sales and preyed on unwitting patients.
Insys paid the doctors, in some cases more than $100,000 annually, in return for prescribing millions of dollars worth of the company’s painkiller product, the indictment said. It charged that Insys funneled the illicit payments to the doctors through a sham “speakers bureau,” in which the doctors were paid for purportedly giving educational presentations about the drug that, in reality, were mere social gatherings at high-end Manhattan restaurants.
The gatherings involved no educational component, and attendance sign-in sheets were often forged to include the names of health care practitioners who were not actually present, the indictment said.
“These prominent doctors swore a solemn oath to place their patients’ care above all else,” said Geoffrey S. Berman, the United States attorney for the Southern District of New York. “Instead, they engaged in a malignant scheme to prescribe fentanyl, a dangerous and potentially fatal narcotic 50 to 100 times more potent than morphine, in exchange for bribes in the form of speaker fees.”
Mr. Berman announced the charges along with William F. Sweeney Jr., the head of the F.B.I.’s New York office. The four other doctors charged in the New York case are Jeffrey Goldstein of New Rochelle, N.Y.; Todd Schlifstein of New York City; Dialecti Voudouris of New York City; and Alexandru Burducea of Little Neck, N.Y.
All five defendants pleaded not guilty in federal court on Friday afternoon and were released on $200,000 bond.
Mr. Berman’s office also disclosed that two former Insys employees — Jonathan Roper and Fernando Serrano — had pleaded guilty and were cooperating with the federal investigation.
Insys, which is based in Arizona, has come under intense scrutiny over its aggressive marketing of Subsys, a form of fentanyl approved in 2012. Subsys is sprayed under the tongue and approved for use only in patients who have cancer and who experience pain even though they are already on round-the-clock painkillers.
The company did not immediately respond to a request for comment.